HomeMy WebLinkAbout20042870.tiff OIL AND GAS DIVISION ORDER
OPERATOR: KERR-MCGEE ROCKY MOUNTAIN CORPORATION Date: August 27,2004
1999 BROADWAY,SUITE 3600 Effective Date: Date of First Production
DENVER,CO 80202 Well Number: 931171
(303)296-3600
Well Name: HSR-HAMMER 6-2
Description: 3N-66W 2 SE/NW SPACING: NIA Copy for your files
Formation: J Sand
County and State: Weld County,Colorado
Owner: Address: Decimal Interest:
WEL210 915 10TH STREET 0.03125000 GAS RI
WELD COUNTY BOARD OF GREELEY CO 80632 0.03125000 OIL RI
COMMISSIONER
The undersigned certifies the ownership of the decimal interest in production or proceeds as described above payable by Kerr-McGee Rocky
Mountain Corporation.
Kerr-McGee Rocky Mountain Corporation shall be held harmless in the event of, and is hereby released from any and all damage or loss which
might arise out of any overpayment or underpayment. The Owner executing this Division Order, in consideration of payments by Kerr-McGee Rocky
Mountain Corporation, agrees to pay any overriding royalty or royalty owners and/or all other persons who may have right, title or interest in the
interest in production set out above and further agrees to protect, indemnify and hold Kerr-McGee Rocky Mountain Corporation harmless from and
against any and all loss, cost or expense which it may suffer or sustain by reason of such payment regardless of how any such claim or demand may
arise,including all costs or expenses incurred by Kerr-McGee Rocky Mountain Corporation in defending its position in any such claim,suit or action.
The undersigned agrees to notify Kerr-McGee Rocky Mountain Corporation, in writing, of any change in ownership, decimal interest, or payment
address. All such changes shall be effective the first day of the month following receipt of such notice.
Kerr-McGee Rocky Mountain Corporation.is authorized to withhold payment pending resolution of a title dispute or adverse claim asserted regarding
the interest in production claimed herein by the undersigned. The undersigned agrees to indemnify and reimburse Kerr-McGee Rocky Mountain
Corporation any amount attributable to an interest to which the undersigned is not entitled.
Kerr-McGee Rocky Mountain Corporation may accrue proceeds until the total amount equals twenty-five dollars($25.00),or pay annually,whichever
occurs first,or as required by applicable state statute.
This Division Order does not amend any lease or operating agreement between the undersigned and the lessee or operator or any other contracts for
the purchase of oil or gas.
In addition to the terms and conditions of this Division Order, the undersigned and Kerr-McGee Rocky Mountain Corporation may have certain
statutory rights under the laws of the state in which the property is located.
The undersigned authorizes Kerr-McGee Rocky Mountain Corporation to withhold from the proceeds of any and all production referred to herein the
amount of any tax placed thereon by any governmental authority and to pay the same on our behalf.
{^ Witness/Attest:
Owner(s)Signature(s): -&, Y l '
Robert D. Masden, Chair G,c Se��.
Gi�i A /J ���
Owner(s)S.S.or Tax I.D.# 84-6000-813 t A► j2 ../'{'/��7/✓(� f
Isal Irlit T:
4 ,„...
" COUNTY CLERK T HE BOARD
Owner Daytime Telephone# 970-356-4000 X4200 `�' �(J��,cf j,�
Owner Fax Telephone# 970-357—n747 NIS, /v�
DEPUTY CLER THE BOA
Federal Law requires you to furnish your Social Security or KMG USE ONLY
Taxpayer Identification Number. ReC'd by Date:
Failure to comply will result in 31%tax withholding and will ReIS'd by Date:
not be refundable by Favor
Approv'd by Date:
2004-2870
el -�0'Oui GEA6,617
EXHIBIT "A"
HSR-HAMMER 6-2 --.1 Sand Formation
Well No. 931171
TOWNSHIP 3 NORTH -RANGE 66 WEST,Section 2: N'/z
320 ACRES, MORE OR LESS
WELD COUNTY, COLORADO
S x y s ^er ..... }*^ *- �n
k" t* + <d '�� 2^� `*pan , " r mu+ t �y3}
.., c:=G_�.,.I5„a�&.� aY t «k. �:..a.x '.�'s
BAA553 LYNN BAALMAN & MARK E. BAALMAN, JT 240/320 ac x 0.0125% MI;12.5%12.5% RI 0.00001171 RI
CLA905 GEORGE W. CLAY, IV& DANA D. CLAY, JT 240/320 ac x 0.145833% MI x 12.5% RI 0.00013672 RI
ESP270 THE ESPERANZA CORPORATION 240/320 ac x 3.5% MI x 12.5% RI 0.00328125 RI
CHARLES GRAZNAK&AUDREY E. GRAZNAK,
GRA961 JT 40/320 ac x 1/2 MI x 12.5% RI 0.00781250 RI
HSR001 KERR-McGEE ROCKY MOUNTAIN CORP. 240/320 ac x 29.083334% MI x 12.5% RI 0.02726563 RI
LOR268 CALVIN C. LORENZ 240/320 ac x 1/6 MI x 12.5% RI 0.01562500 RI
MIL200 MILE HIGH TURKEY HATCHERY, LLC 200/320 ac x 1/2 MI x 12.5% RI 0.03906250 RI
OLD823 OLD WEST TOURS 240/320 ac x 0.104166% MI x 12.5% RI 0.00009766 RI
OSWALD FAMILY TRUST
OSW157 LOUIS A. OSWALD, III, TRUSTEE 240/320 ac x 0.129166% MI x 12.5% RI 0.00012110 RI
JONATHAN S. RODERICK& CAROL
ROD274 RODERICK, JT 240/320 ac x 0.025% MI x 12.5% RI 0.00002343 RI
WAL404 JOHN C. WALLACE 240/320 ac x 0.166667% MI x 12.5% RI 0.00015625 RI
WAL407 THOMAS C. WALLACE 240/320 ac x 0.166667% MI x 12.5% RI 0.00015625 RI
WELD COUNTY BOARD OF
WEL210 COMMISSIONERS 80/320 ac x 12.5% RI 0.03125000 RI
HSR001 KERR-McGEE ROCKY MOUNTAIN CORP. 0.87500000 WI
1.00000000
Page 1 of 1 8/26/2004
KERB-MCGEE ROCKY MOUNTAIN CORPORATION
1999 BROADWAY.SUITE 3600•DENVER.COLORADO 80202
August 27, 2004 PHONE:303-296-3600
FAX:303-296-3601
RE: HSR-Hammer 6-2
Township 3 North,Range 66 West, Section 2: N%
Weld County, Colorado
Dear Interest Owner:
The subject well was recently deepened to the J Sand formation, which is spaced on an 320-acre
unit. The enclosed Division Order reflects your interest in the new formation; your interest in
the existing formation(s) will not change.
Please read the following instructions carefully before signing the enclosed division order:
1. Be sure that your interest is correct.
2. Sign your name in the space provided exactly as it is shown BEFORE TWO WITNESSES.
3. Your SOCIAL SECURITY NUMBER or TAX IDENTIFICATION NUMBER must be
shown in the space provided. Failure to provide the number may result in withholding of
your production proceeds, as required by law, and you may also be subject to a penalty
imposed by the Internal Revenue Service.
4. Verify the address to which checks should be mailed.
5. If the interest is owned by a CORPORATION,the division order must be signed by a duly
authorized officer and attested. The corporate seal must be affixed and the title of the
signing officer shown.
6. If the interest is owned by a PARTNERSHIP, the division order must be signed by the
general partner or managing partner and evidence of such authority to sign must be
furnished.
7. If the division order is signed by anyone other than the named owner such as an AGENT,
ATTORNEY-IN-FACT,or GUARDIAN,evidence of authority must be provided.
After you have completed and signed the division order, please return the original to me. The copy
is for your records. Should you have any questions or concerns, feel free to contact me.
yS
Sincerely, M to _
fl rn
1 l :
;
Erin J. Langdon =
Division Order Analyst
enclosure C)
W
COUNTY ATTORNEY STAFF APPROVAL
This is to affirm the attached Division Order and Authorization to
Receive Payment for an Oil and Gas Well has been reviewed by
the County Attorney's staff as to form, legal description, and
percentage of royalties, if applicab
BY:
Co ttttomey
DATE: 9 I I /Hem )4'
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